A woman's influence to choose mastectomy as treatment for breast cancer.
BACKGROUND
Over a 10-y period at our community hospital, more than 50% of women 40 y of age and younger underwent a mastectomy as first line breast cancer treatment. These results catapulted a study to identify personal and physical implications of a mastectomy and to determine if, in women of all ages, breast conservation therapy with close follow-up is a better alternative to mastectomy.


METHODS
Six hundred eight women underwent a mastectomy for breast cancer from 1989 to 2005 at our teaching institution; 77% (n = 120) of 156 successfully contacted women agreed to participate in the study, and 70% (n = 84) of them completed a questionnaire.


RESULTS
Most women discovered their breast cancer through mammography or self breast examination, 31% and 28%, respectively. Five patients were diagnosed at Stage 0, 35 at Stage 1, 26 at Stage 2, 8 at Stage 3, 1 at Stage 4, and 9 patients had an unknown stage of disease. Sixty-three patients primarily discussed their treatment plan with a surgeon; 80 were satisfied with the time spent discussing their treatment. Twenty-four patients underwent various reconstruction procedures; most (75%) were satisfied with their treatment and reconstruction choices.


CONCLUSIONS
Mastectomy as a treatment choice for breast cancer did not have the negative personal and physical outcome that we had predicted. Personal choice and a surgeon's advice were the primary influencing factors on the women's treatment choice of mastectomy. Adequate preoperative discussion time and a multimodality cancer team can be most helpful in providing comprehensive treatment options for all women with breast cancer.
Fancher
Tiffany T
TT
Department of Surgery, Saint Mary's Health System, Waterbury, CT 06706, USA. tfanche@hotmail.com
Palesty
J Alexander
JA
Thomas
Reney
R
Healy
Tami
T
Fancher
Jennifer M
JM
Ng
Chonn
C
Dudrick
Stanley J
SJ
D000223:Adaptation, Psychological; D001828:Body Image; D001943:Breast Neoplasms / Q000523:psychology / Q000601:surgery*; D003657:Decision Making; D005260:Female; D006801:Humans; D008408:Mastectomy / Q000523:psychology*; D015412:Mastectomy, Segmental / Q000523:psychology; D008875:Middle Aged; D010358:Patient Participation; D017060:Patient Satisfaction; D016387:Women's Health